Autoantibodies to cardiac troponin in acute coronary syndromes

Lindahl, Bertil; Venge, Per; Eggers, Kai M.; Gedeborg, Rolf; Ristiniemi, Noora; Wittfooth, Saara; Pettersson, Kim

doi:10.1016/j.cca.2010.08.005

Cited by 21 publications

(27 citation statements)

References 22 publications

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“…Lindahl et al studied 957 patients with non-ST elevation ACS, with outcomes assessed through 5 years. In this study, despite being associated (as previously described) with chronically elevated troponin concentrations, anticardiac troponin autoantibodies were not independently associated with death and MI during follow-up (50).…”

Section: Myocardial Infarctionsupporting

confidence: 61%

“…Most studies assessed anti-troponin I antibodies (9,12,14,(39)(40)(41)(42)(45)(46)(47)(48)50,51,(53)(54)(55)(56)(57)(58), whereas anti-troponin T antibodies were assessed in only 16% (n=1,636) of individuals (11,43,44,49,52) (including 993 individuals where both types of autoantibodies were evaluated) (11,44,49).…”

Section: Resultsmentioning

confidence: 99%

“…Over half of the studies included assessed individuals with cardiovascular diseases (9,11,12,14,39,40,(44)(45)(46)(47)(48)50,51,53,(55)(56)(57), especially DCM. The prevalence of anti-troponin I autoantibodies in DCM ranged from 7.0% (11) to 22.2% (in patients prior to immunoadsorption, notably decreased to 3.7% after immunoadsorption) (53).…”

Section: Resultsmentioning

confidence: 99%

“…Whereas in some studies autoantibodies were assessed after an acute MI, in others they were assessed after years of cardiovascular disease (such as DCM). As was described in several studies, levels of autoantibodies can vary over time (50,51). In addition, different clinical contexts were assessed, and should be taken into consideration (72).…”

Section: Study Limitationsmentioning

confidence: 99%

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Anti-cardiac troponin antibodies in clinical human disease: a systematic review

Vilela¹,

Bettencourt‐Silva²,

Costa³

et al. 2017

Ann. Transl. Med.

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Anti-cardiac troponin antibodies have been studied in different types of clinical diseases and in healthy populations. A systematic review of published data on anti-troponin antibodies was carried out (search performed on PubMed, ISI Web of Knowledge and Scopus databases). From title and abstract analysis, thirty-three articles were included that met the pre-specified criteria; after full-text analysis, nine articles were excluded. Most studies assessed anti-troponin I antibodies. The prevalence of anti-cardiac troponin antibodies in healthy individuals ranged from 0.0% to 20.0%. The prevalence of anti-troponin I autoantibodies in dilated cardiomyopathy (DCM) ranged from 7.0% to 22.2%. Other conditions under study were myocardial infarction, ischemic cardiomyopathy (ICM), peripartum cardiomyopathy (PPCM), Chagas disease, Emery-Dreifuss muscular dystrophy (EDMD) and renal transplantation. In the different patient populations studied, anti-cardiac troponin antibodies have been shown to be either positively or negatively associated with prognostic and clinical features. In what concerns a possible value as biomarkers, these assays have not emerged up to the present moment as important aids for practical clinical decisions in cardiac or other types of patients. In what concerns pathophysiology, anti-cardiac troponin autoantibodies may play a role in different diseases. It can be speculated that these antibodies could be involved in perpetuating some degree of cardiac injury after an event, such as myocardial infarction or PPCM. The major function of the heart is its contractile function, and cardiac muscle contains sarcomeres, which include different types of molecules, of which actin and myosin are essential for strength generation during contraction. Other molecules, such as cardiac troponins, play a role of regulation concerning cardiac muscle contraction. Cardiac troponins I and T have been shown to be different molecules than the corresponding ones in skeletal muscle, and have gained importance as cardiac biomarkers (1,2).Research has shown that antibodies against cardiac troponins exist in different settings, and questions about their role in the cardiovascular pathological continuum have emerged over the last years. The possible role of cardiac troponin autoantibodies in disease processes [and particularly in dilated cardiomyopathy (DCM) and ischemic cardiomyopathy (ICM)] has gained interest (3-6).Animal models in mice have demonstrated that anticardiac troponin I autoantibodies are capable of inducing heart dilatation and dysfunction, apparently through interactions with the calcium balance in cardiomyocytes (7). Okazaki et al. showed that in mice antibodies to cardiac troponin I stained the surface of cardiomyocytes, implying the presence of troponin I on the cell surface (differing from cardiac troponin T) (7). Göser et al. immunized mice with cardiac troponin I, leading to severe inflammation of the myocardium, cardiomegaly, fibrosis and 30% mortality over 270 days (8). However, in a study carri...

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Section: Myocardial Infarctionsupporting

confidence: 61%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Study Limitationsmentioning

confidence: 99%

See 2 more Smart Citations

Anti-cardiac troponin antibodies in clinical human disease: a systematic review

Vilela¹,

Bettencourt‐Silva²,

Costa³

et al. 2017

Ann. Transl. Med.

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“…In addition, low concentrations of cTnI (2,38 ) and small MRI-detected UMIs (11,39 ) have proven prognostic significance. The observation that cTnI concentrations below the 99th percentile were associated with the development of an MRI-detected UMI suggests that even cTnI concentrations within the reference interval may provide prognostic information, because having such a UMI is associated with increased mortality (9 ).…”

Section: Discussionmentioning

confidence: 99%

Cardiac Troponin I Associated with the Development of Unrecognized Myocardial Infarctions Detected with MRI

et al. 2014

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Multiple immunoassay systems are negatively interfered by circulating cardiac troponin I autoantibodies

Tang

Zhao

et al. 2011

Clin Exp Med

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Circulating cardiac troponin I (cTnI) autoantibodies have recently been detected in more and more patients with myocardial injury. In the present study, a total of 121 patients with acute myocardial infarction (AMI) were screened for cTnI autoantibodies using an indirect ELISA. Positive results were further confirmed by Western blot analysis. As a result, 13 autoantibody-positive sera were identified, in which cTnI values detected by different immunoassay systems are very different. Further evaluation revealed low recovery in one of the 13 samples with the Access 2 system (Beckman Coulter, 2^ generation), one low and one moderate recovery sample with Architect i2000 (Abbott), one low and two moderate with AxSYM (Abbott), two low and three moderate with Dimension Xpand (Dade Behring, 2^ generation), and four low and one moderate with Vidas (bioMérieux). Our work demonstrates that circulating cTnI autoantibodies occur in part of patients with AMI and, for the first time to our knowledge, shows that these autoantibodies can result in considerable negative interference in all the five commonly used cTnI immunoassay systems, which may lead to incorrect diagnoses and following treatments. The indirect ELISA established in our laboratory is suitable for a rapid preliminary screening for cTnI autoantibody in clinical work.

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Autoantibodies to cardiac troponin in acute coronary syndromes

Cited by 21 publications

References 22 publications

Anti-cardiac troponin antibodies in clinical human disease: a systematic review

Anti-cardiac troponin antibodies in clinical human disease: a systematic review

Cardiac Troponin I Associated with the Development of Unrecognized Myocardial Infarctions Detected with MRI

Multiple immunoassay systems are negatively interfered by circulating cardiac troponin I autoantibodies

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